EMOTIONAL AND BEHAVIOURAL PROBLEMS AMONG SHELTERED HOMELESS CHILDREN OF NEPAL
Mental health issues among children and adolescent is now recognized as one of the public health issue. The problem is more complicated in those unfortunate children who do not live in the home. Homelessness is a common phenomenon among Nepalese children. The scene of children begging in the street, picking up garbage, living in the street is a usual scene in city area. Nepal is just out from a decade long conflict where
there were many families displaced from their homes. Other factors leading to homelessness in Nepal are poverty, unemployment, poor education status, singled headed households, unemployment, multiple children, limited support network, exposure to violence, family instability, lack of resources, social discrimination for the lower caste and indigenous minorities. Homelessness have many adverse effects in the development
of a child. Children living out of their homes have problems in attachment, temperament, social skills, cognitive ability, language development. There are few non-governmental organizations who have started to give shelter, food and education for those children. But attempts to measure the mental health needs among those homeless children is none. We attempted to investigate the emotional and behavioural problems in homeless children in one of the shelters in Kathmandu.
To study the emotional and behavioural problems in sheltered homeless children
All the children in one of the Organization were included in the study. They were administered CBCL 6-18 and fed into the computer in Assessment Data Manager. The data on the internalizing and the externalizing dimensions were included. The children with T-score of more than 65 were further subjected to detailed psychiatric evaluation in the Child Guidance Clinic. Then, the final diagnosis was made. The analysis was made on the basis of Borderline (T score >65 and <70), Clinical (T score>70) and final diagnosis.
The prevalence of emotional and behavioural problem was found to be 23.01%. Of which the prevalence in Male was 21.05% and female was 24.63%.Based on T score of 70 as the cut off (98 percentile), this study shows the prevalence of emotional and behavioural problems 28.57% (N=36) among both male and female children. The prevalence of clinical range T score on any of the domain among male children is 26.31% and among female children is 30.43%. The difference is however not significant. The conduct problems is the most common among the male children (14%), followed by anxiety 8.8%, ODD 7%, ADHD 3.5% whereas affective problems were most common in female children ( 20.3%),followed by anxiety 11.6%, conduct 11.6%, somatic problems 2.9%, ADHD 1.4% and ODD 1.4%.
Though our study found that the rate of emotional and behavioral disorder among our homeless children is similar to the school aged non homeless children, as it is not a controlled study and the sample is not randomly taken, the finding cannot be generalized.
Author's Name: Dr. Jasmine Ma